NEJM Journal Watch
By the Editors
The American Academy of Pediatrics has issued a list of five practices to avoid in pediatric neurologic surgery as part of the American Board of Internal Medicine’s Choosing Wisely campaign. Among them:
- Do not routinely perform imaging to evaluate infant head shape, as it unnecessarily exposes the child to radiation. Additionally, positional plagiocephaly and most craniosynostosis cases can be detected via clinical examination.
- Do not routinely perform imaging or elective procedures that call for sedation in very young children with low-risk asymptomatic lesions (for example, small rubbery scalp masses that represent dermoid cysts).
- Do not routinely order computed tomography or magnetic resonance imaging for developmentally normal infants with macrocephaly that’s clinically asymptomatic.